Halo Nevus: Ngesikhathi I-Mole Yakho Ikhula Umjikelezo Ompunga Okwaziyo

I-halo nevus — eyaziwa nangokuthi i-Sutton nevus, leukoderma acquisitum centrifugum, noma i-perinevoid vitiligo — iyinhlobo ye-melanocytic nevus (i-mole) ezungezwe umjikelezo ofanayo (halo) wesikhumba esingaphumuli (ompunga). Le mbonakalo ebonakalayo ibangelwa inqubo ethinta uhlelo lokuzivikela lapho ama-T lymphocytes omzimba ahlasela futhi abulale ama-melanocytes — ama-cells akhiqiza i-pigment — ngaphakathi kwe-mole nasezikhumbeni ezijwayelekile ezizungezile. Ama-halo nevi ajwayelekile kakhulu, athinta cishe amaphesenti ayisishiyagalombili abantu abajwayelekile, nakuba inani langempela lingase libe phezulu njengoba abaningi bengenakubona noma bangabikwe.

Ajwayelekile kakhulu ezinganeni nasezintanjeni, ngokwanda okukhulu ngesikhathi sokukhula, nakuba angathuthukiswa nganoma yisiphi isikhathi. Ama-halo nevi avame ukuvela ngokulinganayo kumadoda nakwabantu besifazane futhi abona phakathi kwezizinda zonke. Ingemuva iyindawo evame kakhulu, ilandela umzimba nezitho.

Ngenkathi umjikelezo ompunga uvame ukujikeleza i-mole esele, ama-halo nevi angathuthukiswa futhi azungeze ama-nevi okuzalwa noma ezinye izilonda ze-melanocytic. I-mole ephakathi ingaba mncane noma iphakeme, ibrown, pink, noma ibala lesikhumba. Ezimweni eziningi, inqubo iqhubeka phakathi kwezinyanga kuya eminyakeni: umjikelezo ompunga uqala kuqala, bese i-mole ephakathi iyashintsha kancane kancane futhi iyanyamalala, ishiyela indawo ejikelezayo yesikhumba esimpunga esizobe sibuya sibe ne-pigment ukuze sifeze isikhumba esizungezile.

Le nqubo yonke ingathatha iminyaka eminingana ukuze iqedwe. Ama-halo nevi ajwayelekile kakhulu futhi akhombisa uhlelo lokuzivikela olusebenza kahle — ngempela, ngokweqile — ngokumelene nama-cells e-melanocytic.

I-halo eliphakeme elizungezile i-halo nevus iyisiphumo esibonakalayo sokuhlasela okuqondile komzimba okukhona emelanocytes. Ucwaningo lukhombisile ukuthi i-ring engashintshile idalwa ama-cytotoxic T lymphocytes (CD8-positive T cells) aqaphela ama-antigens athile emelanocyte njengokungajwayelekile futhi aqala impendulo yokuhlasela komzimba ukuze abhubhise. Lezi T cells zifaka i-nevus kanye nesikhumba esizungezile, zikhulula ama-cytokines futhi zibhubhisa ngqo ama-melanocytes ngama-perforin kanye nezindlela eziphakathi kwe-granzyme.

Le nqubo ifana kakhulu nenqubo ebhubhisa ama-melanocytes ku-vitiligo, kodwa ku-halo nevus, ukuhlasela komzimba kugxile futhi kuqondile endaweni ethile ye-melanocytic. Imibono eminingi ichaza ukuthi kungani uhlelo lokuzivikela lugxila kulezi melanocytes ezithile. Umbono ophakanyisiwe kakhulu uthi ama-melanocytes e-nevus akhombisa ama-antigens angajwayelekile ebusweni bawo — ama-proteins ahluke kulawo ajwayelekile — okukhombisa njengokungajwayelekile uhlelo lokuzivikela.

Lezi zinguquko zingase zibe nemiphumela yokuhlanganiswa kwezinguquko ezidalile ukuthi ama-melanocytes akhe i-nevus ekuqaleni. Omnye umbono uthi uhlelo lokuzivikela lukhomba kahle futhi luhlanza ama-melanocytes angakabi ne-malignant noma angajwayelekile — ngokuyisisekelo lwenza umsebenzi wokuhlola owusizo. Ukuqinisekisa lo mbono, ucwaningo luthole ukuthi ezinye i-halo nevi ziqukethe ama-melanocytes anama-dysplastic features alula.

Naphezu kokuthi umphumela uqondile, impendulo yokuzivikela iyakhanya futhi iyalinganiswa: ama-biopsies e-halo nevi akhombisa i-band-like infiltrate ye-lymphocytes, futhi ama-melanocytes ngaphakathi nangaphandle kwe-nevus akhombisa ubufakazi bokubhujiswa okuhlinzekwa uhlelo lokuzivikela. Lokhu kuyinqubo yokuzivikela enempilo, hhayi isifo.

I-halo nevi ne-vitiligo zabelana ngempela ngempilo — kokubili kubandakanya ukuhlinzekwa kokubhujiswa komzimba kwe-melanocytes — futhi ukuxhumana kwezokwelapha phakathi kwalezi zimo ezimbili kuhlelwe kahle. Abantu abathola i-halo nevi banokwanda okukhulu kwe-vitiligo uma kuqhathaniswa nezixuku ezijwayelekile, futhi abagulayo be-vitiligo bavame ukuba noma bathole i-halo nevi. Ucwaningo luthole ukuthi cishe u-15 kuya ku-25 percent wabaguli be-vitiligo bane-halo nevi, uma kuqhathaniswa no-1 percent wezixuku ezijwayelekile.

Le nqubo ehambisanayo ibandakanya ukuqaphela okuzenzakalelayo kwe-antigens ethile ye-melanocyte, kuhlanganisa i-tyrosinase, i-Melan-A (MART-1), i-gp100 (Pmel17), kanye ne-TRP-1 ne-TRP-2, zonke zihlala zikhona ezikhiqizweni ze-melanin. Ku-vitiligo, le mpahla yokuhlasela iyavela futhi iyakhula, iholela ekwandeni kwemikhawulo yesikhumba esingashintshile. Ku-halo nevus, le nqubo efanayo igxile endaweni eyodwa ye-melanocytic kanye nezindawo eziseduze.

Abanye odokotela bezokwelapha bacabanga ukuthi i-halo nevi iyifomu eliqondile, elizenzakalelayo le-vitiligo eligxile endaweni ye-melanocytic. Umphumela ophathekayo uthi ingane noma intombazane ethola i-halo nevi — ikakhulukazi i-halo nevi eziningi ngesikhathi esisodwa — kufanele ibhekwe ukuze ibonakale izimpawu zokuthuthukiswa kwe-vitiligo, ezingenzeka ezinyangeni noma eminyakeni ezayo. Ngokufanayo, i-halo nevi ingase ibonakale nezinye izimo zokuzivikela ezihlangene ne-vitiligo, kuhlanganisa nezifo ze-thyroid (ikakhulukazi i-Hashimoto's thyroiditis kanye ne-Graves' disease), i-type 1 diabetes, i-pernicious anemia, kanye ne-Addison's disease.

Lokhu akusho ukuthi ukuba ne-halo nevus kuqinisekisa ukuthi uzothola noma yiziphi zalezi zimo — abantu abaningi abane-halo nevi abatholi i-vitiligo noma enye isifo sokuzivikela. Kodwa ukuqwashisa ngalesi sikhathi kuvumela ukuqapha okufanele.

Inani elikhulu le-halo nevi liphila ngokuphelele, futhi ezinganeni nasebantwaneni, ngokuvamile akudingi lutho ngaphandle kokubheka nokukhuthaza. Nokho, ezinye izimo zokwelapha zidinga ukuhlolwa ngokucophelela. Kubantu abadala abangaphezu kweminyaka engama-40 abathola i-halo nevus entsha, ukuqapha okukhulu kuyafaneleka ngoba i-halo phenomenon ingase ibonakale ngezikhathi ezithile emelanin — uhlelo lokuzivikela lukhomba futhi luhlasela ama-melanocytes abhubhayo.

Nakuba le mpahla yokuhlasela emelanin ivamile (ukubuyiselwa kwe-melanoma kuza ne-prognosis engcono kunokungabuyiselwa kwezinye izimo), i-lesion eyinhloko isadinga ukuhlolwa. Noma iyiphi i-halo nevus lapho i-mole eyinhloko ingeyinhle, inemikhawulo engajwayelekile, ibonisa imibala eminingi, noma inkulu kunezikhala eziyisithupha kufanele ihlolwe nge-dermoscopy futhi mhlawumbe ibhujiswe. I-halo nevi enama-halo angajwayelekile (angaphakathi) noma ama-halo angajwayelekile, angahambisani ne-ring ejwayelekile, ayafaneleka ukuhlolwa ngochwepheshe.

I-halo nevi eziningi ezivela kumuntu omdala kufanele zikhuthaze ukuhlolwa okuphelele kwesikhumba somzimba ukuze kuqinisekiswe ukuthi akukhona i-melanoma eyimfihlo kwenye indawo emzimbeni — kwesinye isikhathi ukuvuselelwa komzimba okubangela i-halo nevi eziningi kuqhutshwa yi-melanoma endaweni eyodwa, futhi i-halo phenomenon imele ukuphikisana kokuhlasela kwe-antigens e-melanocyte.!! Le nhlangano ayivamile kodwa ibalulekile kwezokwelapha. Uma i-mole eyinhloko ngaphakathi kwe-halo nevus ingalandeli umqondo ojwayelekile wokuncipha, noma uma iba mnyama, ikhula, ithola i-nodularity, noma igcwala, ukuhlinzwa kuyadingeka. Ngokufanayo, uma i-halo emhlophe iqhubeka nokuhlanganisa izindawo ezinkulu kakhulu zesikhumba ngaphandle kwendawo ethile ye-perinevoid, lokhu kungase kube ukuvela kwe-vitiligo futhi kudinga ukuhlolwa kwezokwelapha.

Umlando wemvelo we-halo nevus ulandela uchungechunge oluqondile oluvamile ukuthi luthathe iminyaka eminingana. Isigaba sokuqala sihilela ukuthuthukiswa kwe-halo emhlophe engashintshile ezungeze i-mole ekhona, ngokuvamile ibonakala kancane kancane phakathi kwezinsuku ezingu- weeks kuya ezinyangeni. Isigaba sesibili sibona i-mole eyinhloko iqala ukufaka nokuncipha, ilahlekelwa ukushintsha njengoba ukuhlinzekwa kokubhujiswa kwe-melanocytes kuqhubeka.

Isigaba sesithathu sihilela ukuhamba ngokuphelele kwe-mole eyinhloko, kushiya indawo ejikelezayo yesikhumba esingashintshile. Isigaba sesine, isigaba sokugcina, sihilela ukuvuselelwa kancane kancane kwendawo emhlophe njengoba ama-melanocytes amasha ehamba ukusuka emaphethelweni nasezindaweni zokukhula, ekugcineni ebuyisela le ndawo emcolor ye-skin ejwayelekile noma ejwayelekile. Le nqubo yonke ingathatha phakathi kweminyaka emibili kuya kwemishado emishayo emishayo, futhi ezinye i-halo nevi zihlala esigabeni esiphakathi isikhathi eside ngaphandle kokuphothula umjikelezo ophelele.

Ukuphathwa kwe-halo nevi ejwayelekile kulula: ukubheka kwezokwelapha nokukhuthaza. Akudingi ukwelashwa kwe-halo nevus uqobo. Ezinganeni nasebantwaneni abane-ukubonakaliswa okujwayelekile — i-mole efanayo enomjikelezo omhlophe, ezinzile noma ethuthuka kancane — ukubheka kwezokwelapha kuphela kuyafaneleka, ngokuhlolwa kokulandela njalo ezinyangeni eziyisithupha kuya kwezingu-12 ukuze kuqinisekiswe ukuhamba okujwayelekile.

Ukuqoshwa ngezithombe zezokwelapha njalo ngenkathi yokuvakasha kusiza ukulandela izinguquko ngendlela efanele. Indawo ye-halo engashintshile kufanele ivikelwe ekukhanyeni kwelanga, njengoba ukungabi khona kwama-melanocytes kusho ukuthi isikhumba kule ndawo sithinteka kakhulu ekulimazeni kwe-UV nase-sunburn.!! I-sunscreen ye-broad-spectrum kufanele ifakwe endaweni engashintshile. Uma ukususa kwe-halo nevus kudingeka ngezizathu zokubukeka noma ukuqinisekiswa kokuhlola, ukuhlinzwa okubandakanya i-nevus eyinhloko kanye nengxenye ye-halo kuyas recommended.

Ukubona i-ring emhlophe ethuthukisa i-mole kungase kube nokukhathazeka — kubukeka kungajwayelekile futhi kuhlukile kunanoma yini oyibonile ngaphambili. I-Skinscanner inikeza umongo kanye nokuhlaziywa okusheshayo uma uthatha isithombe se-mole enehala engashintshile ezungezile. I-AI ihlola izici ze-mole eyinhloko — ukuvumelana kwayo, ukujwayeleka kwemikhawulo, ukujwayeleka kwemibala, kanye nosayizi — kanye ne-pattern ye-halo — ukuvumelana kwayo, ububanzi, kanye nokujwayeleka — ukuze kutholakale ukuthi ukubonakaliswa kuhambisana ne-pattern ejwayelekile ye-halo nevus noma kukhombisa izici ezingajwayelekile ezidinga ukuhlolwa ngochwepheshe.

Lokhu kuqinisekisa kakhulu kubazali abathola i-halo nevus ezinganeni zabo futhi bedinga umhlahlandlela wokuthi ingabe lokhu kuyimbangela yokukhathazeka. I-Skinscanner ingasiza ukuhlukanisa i-halo nevus ejwayelekile kwezinye izimo ezingase zidalule i-ring engashintshile ezungeze i-lesion yesikhumba, kuhlanganisa i-melanoma enokubuyiselwa kanye ne-halo phenomenon ezungeze i-dysplastic nevus. Kubantu abaziwa nge-halo nevi, ukuhlohla okujwayelekile kulandela ukuhamba phakathi kwezinyathelo ezilindelekile — ukuthuthukiswa kwe-halo, ukuncipha kwe-mole, ukubuyiselwa okuphelele, kanye nokuvuselelwa — kunikeza imibhalo yokubona eqinisekisa ukuhamba okujwayelekile noma ibonisa noma yiziphi izinguquko ezivela kumjikelezo olindelekile.

I-Skinscanner ayithathi indawo yokuhlola ye-dermatoscopic, ehlinzeka ngemininingwane emikhulu engaphansi komhlaba engathathwa izithombe ezijwayelekile. Noma iyiphi i-halo nevus engajwayelekile — ikakhulukazi kubantu abadala — kufanele ihlolwe ngochwepheshe nge-dermoscopy futhi mhlawumbe ibhujiswe ukuze kuqinisekiswe i-histologic. Kodwa ukuze kuhlolwe kuqala nokuhlola okuqhubekayo kwe-halo nevi ejwayelekile, i-Skinscanner inikeza umhlahlandlela ofinyeleleka, onolwazi.